Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.
Department of Ophthalmology, Hanyang University Seoul Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.
BMC Ophthalmol. 2021 Mar 22;21(1):145. doi: 10.1186/s12886-021-01908-4.
Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle-closure (PAC). Additionally, we aimed to analyze events that could affect CCT.
In this retrospective study, 26 patients with PAC who had a follow-up period of more than 5 years were analyzed. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle-closure attack was analyzed using the repeated linear mixed model analysis.
A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was - 0.72 ± 0.22 μm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was - 0.53 ± 0.25 μm/yr (P = 0.034) and that of the surgical trabeculectomy group was - 1.32 ± 0.43 μm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle-closure attack was - 0.81 ± 0.31 μm/yr (P = 0.009) and that in patients without an attack was - 0.63 ± 0.30 μm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001).
We found a significant reduction in CCT over a long observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle-closure attacks. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients.
中央角膜厚度（CCT）及其与眼内压的关系，眼内压是青光眼管理的关键参数，此前已有报道。本研究旨在探讨原发性闭角型青光眼（PAC）患者 CCT 的长期变化率。此外，我们旨在分析可能影响 CCT 的事件。
在这项回顾性研究中，分析了 26 例 PAC 患者，这些患者的随访时间超过 5 年。通过平均随访期间的连续 CCT 测量来评估 CCT 从基线开始的变化率。使用重复线性混合模型分析，根据治疗方式和闭角发作史分析 CCT 变化率的模式。
共纳入 52 只眼。整个研究人群的 CCT 降低率为-0.72±0.22μm/yr（P=0.001），具有统计学意义。激光周边虹膜切除术（PI）组的 CCT 变薄率为-0.53±0.25μm/yr（P=0.034），手术小梁切除术组为-1.32±0.43μm/yr（P=0.002），但无统计学意义（P=0.112）。有急性闭角发作史的患者 CCT 变薄率为-0.81±0.31μm/yr（P=0.009），无发作史的患者为-0.63±0.30μm/yr（P=0.001），无统计学意义（P=0.680）。基线 CCT 似乎是唯一影响 CCT 变化率的重要因素（P<0.001）。
我们发现 PAC 眼的 CCT 在长时间观察期间显著降低。我们还发现，CCT 减少率不受不同治疗方式或急性闭角发作的影响。结合基线 CCT 分析 CCT 的长期变化也有助于 PAC 患者的临床评估。
